Interdisciplinary Team Pilot to Reduce Time to Administration of Piperacillin/Tazobactam in the Emergency Department at a Veterans Affairs Medical Center
Madeline M DiVittorio,1 Tracy Fisher,2 Brendan Steadman,2 Brian Cone,2 Zane Elfessi1– 3 1Department of Pharmacy, Jesse Brown Veterans Affairs Medical Center, Chicago, IL, USA; 2Department of Emergency Medicine, Jesse Brown Veterans Affairs Medical Center, Chicago, IL, USA; 3University of Illinois-Ch...
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| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Dove Medical Press
2025-02-01
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| Series: | Journal of Multidisciplinary Healthcare |
| Subjects: | |
| Online Access: | https://www.dovepress.com/interdisciplinary-team-pilot-to-reduce-time-to-administration-of-piper-peer-reviewed-fulltext-article-JMDH |
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| Summary: | Madeline M DiVittorio,1 Tracy Fisher,2 Brendan Steadman,2 Brian Cone,2 Zane Elfessi1– 3 1Department of Pharmacy, Jesse Brown Veterans Affairs Medical Center, Chicago, IL, USA; 2Department of Emergency Medicine, Jesse Brown Veterans Affairs Medical Center, Chicago, IL, USA; 3University of Illinois-Chicago College of Pharmacy, Chicago, IL, USACorrespondence: Zane Elfessi, Email zane.elfessi@va.govBackground: Sepsis is a condition of life-threatening organ dysfunction caused by a dysregulated host response to an infection. Adults with suspected sepsis or possible septic shock should receive antimicrobials within 1 hour. Early administration of antibiotics to patients with sepsis has been shown to decrease in-hospital mortality. Factors that affect antibiotic administration time include the antibiotic dispensary location, best practice alerts in electronic medical records, and staff “huddles” to continuously reinforce the importance of antibiotics.Methods: At our Veterans Affairs Medical Center, we moved piperacillin/tazobactam from the central pharmacy to the emergency department automated dispensing cabinet. We implemented an interdisciplinary sepsis team comprised of emergency medicine (EM) nurses, pharmacists, and physicians. This was a retrospective chart review to assess whether our change in practice affected the time to administration of piperacillin/tazobactam in the emergency department. We assessed whether the change in practice had an effect on mortality in our population.Results: Patients were reviewed 6 months pre- and post-implantation of the practice changes. There were 139 veterans in the pre-implementation group and 128 in the post-implementation group. The two groups were similar in age, sex, and African-American race. There was a statistically significant reduction in the average time from EM pharmacist verification to nurse administration when comparing the groups (46.5± 49.8 vs 30.6± 28.7 minutes, p=0.004). There were statistically significant reductions in the time from EM physician recognition to pharmacist order verification (54.37± 50.22 vs 40.52± 31.26 minutes, p=0.009). Eight patients died in the pre-pilot group compared to five in the post-pilot group. The relative risk of mortality was reduced between the two groups by 32%.Conclusion: When piperacillin/tazobactam was stocked in the emergency department and we implemented an interdisciplinary sepsis team, there was a significant reduction in the time to administration in patients with sepsis.Keywords: sepsis, veteran, interdisciplinary, emergency, antibiotic, piperacillin/tazobactam |
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| ISSN: | 1178-2390 |